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Obesity Rates Level Off, But Health Concerns Remain

There's a little bit of good news in the battle against obesity and weight gain. Two studies this week from the Centers for Disease Control and Prevention suggest that Americans may finally be responding to public health messages warning against problems that result from obesity.

Researchers compared yearly health statistics measuring the height and weight of thousands of adults over the past decade. They found that from 1999 through 2008, the prevalence of obesity among women hit a plateau. Men lagged a bit behind women; it took longer for obesity rates to level off for them, but for the period from 2003 to 2008, obesity prevalence among men didn't increase.

Dr. Bill Dietz, who directs the CDC Division of Nutrition, Physical Activity and Obesity, says the changes likely began with women. "That makes sense because women are the early adopters of healthy behaviors," he says.

In a second study, researchers found that body mass index (BMI) among children and teens also remained relatively stable over the past 10 years. Dietz says that also makes sense because "women are the providers in families; they're also the ones that generally buy the food, prepare it and serve it."

Schools have also made positive changes by trying to offer more healthy alternatives, Dietz says. "Schools are not serving as much high-fat, high-salt snack foods and sugar-sweetened beverages and other high-calorie foods," he says.

Over the past decade, many school districts have removed vending machines that offer unhealthy snacks. More schools are trying to prepare healthier lunches, and are even offering salad bars as a lunch option.

There is, however, one exception to the leveling off of obesity rates. CDC epidemiologist Cynthia Ogden says the heaviest boys are getting even heavier. Data showed an increase in obesity prevalence among boys ages 6 to 19 who were considered obese and at the very heaviest weight levels. "More research is needed to identify the behavioral, biological and environmental factors sustaining these levels of high BMI in U.S. children," the authors conclude.

And even though this is all good news for the majority of U.S. adults and children, it's clearly not time to start rejoicing. The problem may not be getting worse, but health officials say it's not getting better. Today, 17 percent of American children are considered obese, and two-thirds of U.S. adults are overweight or obese.

A recent CDC study finds that the health care costs of obesity related problems continue to climb, says Dietz. It now accounts for nearly 10 percent of the health care budget, an estimated $150 billion. Dietz says the high cost comes from the increased frequency of doctor visits, more expensive and probably more hospitalizations, as well as higher drug costs that are associated with obesity. Those costs aren't due to obesity alone, he says, but cancer, heart disease, Type 2 diabetes and arthritis are also associated with obesity.

Pretty much anyone can attest to the difficulties involved in losing weight. Compared with other unhealthy habits like smoking, for example, losing weight is more complicated. While it's hard to quit smoking, the message is simple: quit. Losing weight, on the other hand, has to do with a number of things, says Dr. Michael Gaziano, a cardiologist at the VA Boston Healthcare System and the Brigham and Women's Hospital.

"Part of the problem is that we tend to learn how to eat in our 20s and 30s. Then our caloric needs change. We go from working on the loading docks to sitting behind a desk, for instance; or from being very active in our work life to retiring; and we don't necessarily make commensurate adjustments in our diet," says Gaziano. The caloric needs of a 75-year-old, for example, are far less than the caloric needs of a 25- or 30-year-old.

Middle-aged and older Americans tend to be more overweight than their younger counterparts. Gaziano recommends diets for his patients based on their age and activity level. As for exercise, no matter what age, he suggests daily aerobic exercise for at least 30 minutes, weekly strength and flexibility training, and opting for the more active alternative: walking, for example, instead of driving, and taking the stairs instead of the elevator.

Both CDC studies appear in the Jan. 20 issue of the Journal of the American Medical Association and are being published early online.